A simple tape measure could become a key medical weapon in this country's war against obesity with the release today of national guidelines urging doctors to routinely check waist circumferences.

The guidelines will recommend that waist size become a standard measurement, along with height and weight, and the data be used in a national surveillance system that can track obesity.

Researchers say doctors often fail to measure abdominal fat, a key indicator of diabetes, coronary and immune system risks.

The new guidelines also include routine blood sugar measurements for overweight patients after age 10; a two-hour-a-day limit on computer and television viewing; and in-office counselling on diet and exercise for overweight patients.

The guidelines, published in the Canadian Medical Association Journal, mark Canada as the first country to develop a comprehensive set of guidelines to prevent and manage obesity.

"The new guidelines send a clear message both to health professionals and policy makers that obesity really is a chronic disease and (should) be addressed as a chronic disease," says Dr. Arya Sharma, a McMaster University medical professor and one of the report's key organizers.

"Unfortunately, it's very often the case that obesity is done away with as a lifestyle flaw, that it's not really a medical issue, it's really a cosmetic issue," says Sharma, director of the federally funded Canadian Obesity Network.

The report's 76 guidelines were developed over two years by a panel of experts under the guidance of the non-profit Obesity Canada group. The guidelines also recommend:

Body Mass Index measurements be taken on all Canadians from the age of 2.

Patients in weight management programs be provided with behavioural modification techniques in addition to other lifestyle modification strategies. These programs can be done by a physician or through associated "family health teams."

School programs to promote healthy living and eating habits be launched across the country and include more physical education classes.

Treatment with medications and bariatric (stomach stapling) surgery be considered for patients for whom dietary and lifestyle counselling fails to work.

The number of obese Canadians has skyrocketed in the past three decades, with an estimated 59 per cent of the population considered overweight. Some 23 per cent of those are considered obese.

About 50 per cent of Canadians carry excess weight around their abdomens.

University of Toronto obesity expert Harvey Anderson welcomed the new guidelines.

"I think it's (important) that physicians were given some concrete responsibility towards helping out with the obesity epidemic," says Anderson, a professor of nutritional sciences in the faculty of medicine.

Anderson says doctors were often loath to provide obesity counselling because it was time consuming and something they were not paid for under provincial billing formulas.

But "physicians have that power of authority and people tend to listen more to them," he says.

Many of the guidelines are common sense, but they were being largely ignored in the modern world, Anderson says.

Anderson says waist measurements are a crucial indicator of obesity dangers because so called "bad fats" are often stored in the body's mid section.

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